# Bacterial contamination and infection control practices in the mortuary at Mbarara Regional Referral Hospital, Uganda

## TL;DR

This study found high levels of drug-resistant bacteria in a Ugandan hospital mortuary, highlighting the need for better infection control practices.

## Contribution

The study provides novel data on bacterial contamination and antimicrobial resistance in a hospital mortuary environment in Uganda.

## Key findings

- Klebsiella species and Staphylococcus aureus were the most common bacteria isolated from mortuary surfaces.
- Methicillin-resistant Staphylococcus aureus (MRSA) was detected in 98% of isolates.
- Azithromycin and Ciprofloxacin showed the highest efficacy against multidrug-resistant bacteria.

## Abstract

Increasing evidence demonstrates that medical personnel and the clinical environment such as surfaces and equipment are often sources of infections. However, limited data exists on the bacterial contamination of the hospital mortuary environment within a hospital setting.

This study aimed to determine bacterial profiles, assess antimicrobial susceptibility patterns, and evaluate infection prevention and control (IPC) practices at the Mbarara Regional Referral Hospital (MRRH) mortuary in southwestern Uganda.

This was a cross-sectional study involving qualitative and quantitative data collection methods. Ninety-three (93) surface swab samples from the inanimate surfaces were collected. Using standard operating protocols, the collected samples were processed at the microbiology laboratory. All isolates were cultured and identified by Gram staining and biochemical tests. Antimicrobial susceptibility testing was done on each isolate following the Kirby-Bauer disk diffusion method. Data was entered and analyzed using SPSS version 26 and results were explained by percentages and tables.

Klebsiella species were the most predominant isolated bacteria (44.7%) followed by Staphylococcus aureus (40.3%). Methicillin-resistant Staphylococcus aureus (MRSA) was detected at a high frequency (98%). Resistance patterns showed that most isolates exhibited multidrug resistance, with high resistance to commonly used antibiotics. However, Azithromycin and Ciprofloxacin demonstrated the highest efficacy against both Gram-positive and Gram-negative isolates.

Inanimate surfaces and equipment of the mortuary are heavily contaminated with multidrug-resistant bacteria such as Methicillin-resistant Staphylococcus aureus. Improper disinfection and waste segregation may contribute to bacterial contamination in the mortuary. Regular and enhanced cleaning with disinfectants, proper use of clean aprons, and displaying safety signage for workers and visitors can help improve infection prevention and control.